Individual provider Active NPI

Shirley L Cameron, CRNA

  • Certified Registered Nurse Anesthetist
  • Elyria, OH
National Provider Identifier
1932212974
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
143304 Issued in OH
Practice address
860 E Broad St
Suite I
Elyria, OH 44035-6542
Phone
(440) 323-8458
Fax
(440) 323-7900
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 143304 OH Primary

Addresses

Primary practice location

860 E Broad St
Suite I
Elyria, OH 44035-6542

Mailing address

3500 Cook Rd
Medina, OH 44256-9233
Phone (330) 723-7907

Other identifiers 1

IdentifierTypeStateIssuer
0776352MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
143304OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Mansfield, Inc PastSince Jan 15, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932212974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 COOK RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569233",
            "telephone_number": "330-723-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 E BROAD ST",
            "address_2": "SUITE I",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356542",
            "telephone_number": "440-323-8458",
            "fax_number": "440-323-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "SHIRLEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "143304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0776352",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.